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, ' CITY OF ORONO * z 0 1 2 - 0 0 7 5 7 * <br /> 2750 KELLEY PARKWAY UATE ISSUED: 08/03/2012 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 2691 CAROLINE AVE <br /> PIN : 20-117-23-24-0025 <br /> LEGAL DESC : REG. LAND SURVEY NO. 0115 <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHAMCAL-MULTIPLE <br /> VALUATION : $ 7,750.00 <br /> NOTE: 1 LENNOX NG FURNACE <br /> 1 LENNOX 2.5 TON AC <br /> APPLICANT MECHANICAL 96.88 <br /> GOLDEN VALLEY HEATING&AIR STATE SURCHARGE MECH (VALUATION) 3.88 <br /> 5182 WEST BROADWAY <br /> CRYSTAL, MN 55429- MAIL-IN FEE 2.p� <br /> (612)535-2000 MISC FEE 0.00 <br /> TOTAL 102.77 <br /> OWNER <br /> PULVER, THELMA <br /> 2691 CAROLINE AVE <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> Thc work for which this permit is issued shall be performed according to <br /> the approved plans and specifieations,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separatc <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within I 80 days oP the date of issuance,or if construction is <br /> suspended tbr a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked a[any time for due cause. ' <br /> ��'►ti� �' l l ll-�-a.-„�__ l l <br /> Applicant Permitee Signature Date Issued E3y Si ature Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED ABOVE. <br />